Journal of Orthopaedic Science最新文献

{"title":"Comparison of the radiological and functional results of a plaster splint and dynamic stabilization splint for Boxer's fractures: A prospective randomized controlled study","authors":"","doi":"10.1016/j.jos.2023.08.004","DOIUrl":"10.1016/j.jos.2023.08.004","url":null,"abstract":"<div><h3>Purpose</h3><p>This study compared the clinical and radiological results of fifth metacarpal neck fractures treated with a short-arm plaster splint (SAPS) versus a dynamic metacarpal stabilization splint (DMSS).</p></div><div><h3>Materials and methods</h3><p>The 119 patients were referred to our institute between 2018 and 2019 and treated with SAPS or DMSS after appropriate initial closed reduction<span>. Follow-up examinations were conducted at days 10 and 20, and at 1, 2, and 3 months after treatment. Alignment of the fracture, range of motion (ROM), and complications were evaluated during each visit. Grip strength was evaluated using a dynamometer. Self-care, usual daily activities, pain/discomfort, and anxiety/depression were evaluated using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) and a VAS.</span></p></div><div><h3>Results</h3><p><span>Of the 119 patients, 103 completed all follow up examinations. In total, 51 patients were treated with SAPS and 52 with DMSS. Skin lesions were detected in five patients in the DMSS group, but none in the SAPS group (p = 0.008). The grip strength of patients in the DMSS group was statistically better at the 1-, 2-month and 3-month follow-up visits (p &lt; 0.001). ROM of the interphalangeal and </span>metacarpophalangeal joints were statistically better in the DMSS group at the 1-month visit (p &lt; 0.001) but similar at the 3-month visit (p = 0.27). Wrist ROM was statistically higher in the DMSS group at the 3-month visit (p &lt; 0.05). Self-care, usual daily activities, pain/discomfort, and anxiety/depression were statistically better in the DMSS group at all follow-up visits (p &lt; 0.05), as determined by the EQ-5D-5L.</p></div><div><h3>Conclusion</h3><p>Dynamic stabilization of a stable boxer's fracture with DMSS is as effective as static stabilization with SAPS for maintaining the reduction and ensuring union. However, DMSS provides better early ROM, comfort, and muscle strength, as well as an earlier return to usual daily activities despite the occasional skin lesions happened.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1196-1202"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9991015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to letter to the editor by Li et al.","authors":"","doi":"10.1016/j.jos.2024.06.001","DOIUrl":"10.1016/j.jos.2024.06.001","url":null,"abstract":"","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1335-1336"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel diagnostic examination for dropped head syndrome (DHS) (Prone position cervical extension test; DHS test)","authors":"","doi":"10.1016/j.jos.2023.09.003","DOIUrl":"10.1016/j.jos.2023.09.003","url":null,"abstract":"<div><h3>Background</h3><p><span><span>Dropped head syndrome (DHS) is followed by severe cervical extension muscle weakness that results in chin-on </span>chest deformity. However, maintaining a neutral cervical position can be temporarily possible, and the diagnosis of DHS might sometimes be difficult. The purpose of the present study is to examine a novel clinical test (DHS test) as the diagnostic utility for objective evaluation that focuses on cervical extension condition in the </span>prone position.</p></div><div><h3>Methods</h3><p>One hundred subjects were diagnosed with isolated neck extensor myopathy<span> (INEM)-DHS at our hospital (17 men and 83 women, mean age 75.0 ± 8.5 years), and 62 subjects were enrolled as age-matched controls. The DHS test consisted of three examinations; the first was “Ceiling gazing test” in standing position, the second was horizontal gazing in “Sphinx prone position test”, and the third was horizontal gazing in “Hands and knees prone position test”. We investigated the sensitivity and specificity of the DHS test for DHS.</span></p></div><div><h3>Results</h3><p>The patients showing positive in the INEM-DHS group were 63/100 in Ceiling gaze test, 73/100 in the Sphinx prone position test, and 91/100 in the Hands and knees prone position test. In the control group, 0/62 patients presented positive in the Ceiling gaze test, 4/62 in the Sphinx prone position test, and 0/62 in the Hands and knees prone position test. Sensitivity and specificity of the DHS test were 63.0%/100%, 73.0%/93.5%, and 91.0%/100% in the Ceiling gaze test, Sphinx position prone position test, and Hands and knees prone position test, respectively.</p></div><div><h3>Conclusion</h3><p>The prone position cervical extension test (DHS test) would be useful as a novel objective diagnostic tool for INEM-DHS.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1179-1182"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41236238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial patient demographics affecting return to original work after traumatic hand injury in a rural area in Japan: A retrospective single-center study","authors":"","doi":"10.1016/j.jos.2023.09.002","DOIUrl":"10.1016/j.jos.2023.09.002","url":null,"abstract":"<div><h3>Background</h3><p>Time off work after traumatic hand injury not only affects individuals but also has socioeconomic repercussions, becoming a serious problem from the viewpoint of labor shortages. In depopulated rural areas, the impact of labor shortages due to time off work is more serious than in urban areas; however, few studies have examined return to original work in rural areas. The purpose of this study was to investigate the patient demographics at the time of hand injury that affect return to original work in a rural area of Japan.</p></div><div><h3>Methods</h3><p><span>We retrospectively examined 246 patients with traumatic hand and/or forearm injuries who were working at the time of injury, and who underwent surgical operations and postoperative rehabilitation in a level II hospital in a rural agricultural area. We examined patients' initial demographic data, including gender, age, occupation (white or blue collar), employment status (self-employed, full-time, or part-time workers), complications other than hand injury, workers’ compensation, dominant hand injury, and </span>injury severity<span> as determined using the modified Hand Injury Severity Score<span>. Multivariate logistic regression analysis examined the association between initial patient demographics and return to original work within 150 days after injury.</span></span></p></div><div><h3>Results</h3><p>In total, 186 patients (76 %) were able to return to original work within 150 days. A multivariate logistic regression analysis showed that three explanatory variables (i.e., severity of injury, complications other than hand injury, and female gender) significantly compromised return to original work.</p></div><div><h3>Conclusions</h3><p>In the treatment of traumatic hand injury, intensive support should be provided for return to original work for patients who are expected to have difficulty returning to work quickly. In addition, labor shortages can be mitigated by sharing information with the workplace about patients’ prospects of return to original work.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1280-1286"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41236240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiome of infected fracture nonunion: Does it affect outcomes?","authors":"","doi":"10.1016/j.jos.2023.08.018","DOIUrl":"10.1016/j.jos.2023.08.018","url":null,"abstract":"<div><h3>Background</h3><p>Infected fracture nonunions<span> often require prolonged treatment and recovery courses. It is unclear whether the bacterial microbiome<span> influences the time to healing as well as the eradication of infection. The goals of this study are (1) to assess the bacterial microbiome affecting infected nonunions and (2) to evaluate the effects of bacterial speciation on associated outcomes.</span></span></p></div><div><h3>Methods</h3><p><span>Between 2006 and 2022, data from 551 adult patients from a single academic institution who presented with a fracture nonunion were analyzed retrospectively for infection. All patients underwent revision surgery with three sets of cultures obtained intra-operatively. Patients with significant intra-operative cultures were grouped into gram-positive and gram-negative culture cohorts. These patients were managed with a standardized protocol involving surgical debridement, nonunion site fixation, and culture-directed </span>antibiotic<span> treatment. Primary outcome was time to fracture union<span>. Secondary outcomes included number of re-operations and eventual amputation or reconstructive surgery.</span></span></p></div><div><h3>Results</h3><p><span>56 nonunion patients (10 %) were diagnosed with an infected nonunion (44 g-positive, 12 g-negative). Of these, 3 g-positive patients received an amputation or arthroplasty procedure prior to </span>fracture union, and seven were lost to follow-up. There were no significant differences in age, gender, or nonunion site between cohorts. Most nonunions occurred in the lower extremity. The most common bacteria were staph species (54.3 %). 36 g-positive and 10 g-negative patients achieved fracture union. Time to union was on average 158.4 days longer in the gram-negative cohort—but did not reach statistical significance (446.8 days gram-positive, 662.3 days gram-negative, p = 0.69). There was no difference in re-operation rates (1.9 % gram-positive, 2.2 % gram-negative, p = 0.84).</p></div><div><h3>Conclusions</h3><p>Patients with infected nonunions had wide-ranging bacterial contamination that were treated successfully using a standardized protocol. However, patients with any gram-negative culture trended toward a delay in time to union.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1270-1273"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41236242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observational study of ropivacaine and compound betamethasone mixture for analgesia after triangular fibrocartilage complex repair under wrist arthroscopy: A single-center randomized double-blind controlled trial","authors":"","doi":"10.1016/j.jos.2023.08.017","DOIUrl":"10.1016/j.jos.2023.08.017","url":null,"abstract":"<div><h3>Background</h3><p><span><span>The purpose of this study was to investigate the clinical effect of an intra-articular and local infiltration injection of a compound analgesic mixture of </span>ropivacaine<span> and compound betamethasone on the repair of the </span></span>triangular fibrocartilage<span> complex under wrist arthroscopy.</span></p></div><div><h3>Methods</h3><p>This prospective, double-blind, randomized study involved 20 patients with Atzei type 2 or 3 injuries of the triangular fibrocartilage complex who underwent repair under wrist arthroscopy. Patients were divided into two groups (n = 10) according to the systematic random sampling method. The test group was injected with a “cocktail” mixture for pain relief. The control group was injected with normal saline. The visual analog scale (VAS) pain score, pinch force, wrist joint mobility, wrist joint function score (PRWE score), occurrence of adverse reactions and dosage of analgesic drugs were evaluated before and after the operation in the two groups.</p></div><div><h3>Results</h3><p>The resting pain of the patients in the test group was less severe than that of the control group at 12 h, 24 h and 48 h after the operation (P &lt; 0.05), and the pinch force of the patients in the test group was significantly greater than that of the control group at 1 d, 2 d and 3 d after the operation (P &lt; 0.01). The amount of postoperative analgesics used in the test group was significantly lower than that in the control group (P &lt; 0.01), and the patient satisfaction rate in the test group was higher than that in the control group (P &lt; 0.05). There were no postoperative adverse effects in either group.</p></div><div><h3>Conclusion</h3><p>An intra-articular and local infiltration injection of a “cocktail” analgesic mixture in the repair of triangular fibrocartilage complex under wrist arthroscopy can provide good pain control in the early postoperative period and reduce the amount of postoperative analgesic drugs administered, thus improving clinical safety.</p></div><div><h3>Level of evidence</h3><p>Level II; Randomized Controlled Trial; Treatment Study.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1208-1213"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49678784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error of intraoperative measurement of stem anteversion is decreased by measuring in neutral hip position during total hip arthroplasty","authors":"","doi":"10.1016/j.jos.2023.08.008","DOIUrl":"10.1016/j.jos.2023.08.008","url":null,"abstract":"<div><h3>Background</h3><p><span>Intraoperative stem anteversion, which is the angle between the lower leg axis and the trial-stem axis with hip flexion and adduction, is generally evaluated by the surgeon's visual estimation during </span>total hip arthroplasty<span> (THA). However, the conventional approach can be influenced by knee osteoarthritis or uncertain surgeon's observation point. Therefore, we developed a new method for measuring the stem anteversion angle in the neutral hip position using an original rod attached to the trial-stem perpendicular to the long axis and parallel to the stem neck. This study aimed to assess the accuracy of our method in comparison with the conventional method of measuring intraoperative stem anteversion angle.</span></p></div><div><h3>Methods</h3><p>We measured the intraoperative stem anteversion angle in consecutive 106 hips of 106 patients who underwent cementless primary THA with a tapered wedge stem. Absolute error in the stem anteversion angle was expressed as the difference between intraoperative (common vs. neutral hip positions) and postoperative computed tomography measurements, i.e., true stem anteversion. Additionally, we investigated the factors affecting these errors.</p></div><div><h3>Results</h3><p>The absolute error of measurement was significantly smaller in the neutral hip position than in the common position (3.0° ± 2.5° vs. 8.0° ± 3.9°; <em>p</em><span> &lt; 0.0001). The factor associated with the error was advanced knee osteoarthritis in the common position, whereas it was not statistically significant in the neutral hip position.</span></p></div><div><h3>Conclusions</h3><p>This study suggests that the error in the intraoperative measurement of stem anteversion is decreased by measuring in the neutral hip position during THA.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1235-1241"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10381637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of and risk factors for poor outcomes in children with bacterial culture-negative septic arthritis of the hip","authors":"","doi":"10.1016/j.jos.2023.08.009","DOIUrl":"10.1016/j.jos.2023.08.009","url":null,"abstract":"<div><h3>Background</h3><p>Septic arthritis<span><span> of the hip is a serious infection in children. However, blood and joint fluid<span> cultures are often negative, which makes the diagnosis and treatment challenging. We analyzed the clinical features of children with septic arthritis of the hip with negative </span></span>bacterial cultures and identified the risk factors for poor outcomes.</span></p></div><div><h3>Methods</h3><p>The clinical data of children with septic arthritis of the hip with negative bacterial cultures who were treated at our hospital from January 2010 to December 2020 were retrospectively analyzed. The clinical characteristics and outcomes of the culture-negative cohort were compared with those of children with positive bacterial cultures treated during the same period. Culture-negative patients were divided into a group with good outcomes and a group with poor outcomes. The differences between the two groups were compared.</p></div><div><h3>Results</h3><p><span>Thirty-nine children with culture-negative septic arthritis of the hip were compared with 37 children with culture-positive sepsis. Compared with the culture-positive group, the culture-negative group had a significantly younger mean age and a significantly lower mean serum C-reactive protein concentration. </span>Logistic regression analysis of culture-negative patients with good versus poor outcomes revealed that the independent risk factors for poor outcomes were an increased serum C-reactive protein concentration and prolonged time from onset to surgery. The cut-off values for predicting a poor outcome in the culture-negative group were a time from onset to surgery of greater than 21 days and a C-reactive protein concentration of greater than 23 mg/L.</p></div><div><h3>Conclusions</h3><p>Culture-negative septic arthritis of the hip has similar clinical features to culture-positive septic arthritis of the hip and can result in sequelae of varying severity. Therefore, active anti-infective and hip drainage therapy should be performed when children present with clinical symptoms, inflammatory marker concentrations, and imaging findings that are clinically diagnostic for septic arthritis of the hip.</p></div><div><h3>Level of evidence</h3><p>Level II, retrospective study.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1294-1299"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10403012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Yokoya et al. : Factors affecting stress shielding and osteolysis after reverse shoulder arthroplasty: A multicenter study in a Japanese population","authors":"","doi":"10.1016/j.jos.2024.04.013","DOIUrl":"10.1016/j.jos.2024.04.013","url":null,"abstract":"","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1333-1334"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readability and quality of online patient resources regarding knee osteoarthritis and lumbar spinal stenosis in Japan","authors":"","doi":"10.1016/j.jos.2023.08.003","DOIUrl":"10.1016/j.jos.2023.08.003","url":null,"abstract":"<div><h3>Background</h3><p><span><span>This study aimed to quantify the readability and quality of online patient resources on </span>knee osteoarthritis and </span>lumbar spinal stenosis in Japan.</p></div><div><h3>Methods</h3><p><span>Three search engines (Google, Yahoo, and Bing) were searched for the terms knee osteoarthritis and </span>lumbar spinal stenosis<span>. The first 30 websites of each search were screened. Duplicate websites and those unrelated to the searched diseases were excluded. The remaining 125 websites (62 on knee osteoarthritis, 63 on lumbar spinal stenosis) were analyzed. The text readability was assessed using two web-based programs (Obi-3 and Readability Research Lab) and lexical density. Website quality was evaluated using the DISCERN score, Clear Communication Index, and Journal of American Medical Association benchmark criteria.</span></p></div><div><h3>Results</h3><p>Readability scores were high, indicating that the texts were difficult to understand. Only 24 (19%) and six (5%) websites were classified as average difficulty readability according to Obi-3 and Readability Research Lab, respectively. The overall quality of information was low, with only four (3%) being rated as having sufficient quality based on the Clear Communication Index and Journal of American Medical Association benchmark criteria. None of the websites satisfied the DISCERN quality criteria.</p></div><div><h3>Conclusions</h3><p>Patient information on Japanese websites regarding knee osteoarthritis and lumbar spinal stenosis were difficult to understand. Moreover, the quality of the websites was insufficient. Orthopaedic surgeons should contribute to the creation of high-quality easy-to-read websites to facilitate patient-physician communication.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1313-1318"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10406310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}